Sensemaking, safety, and cooperative work in the intensive care unit.
This study examined sensemaking within the context of the intensive care unit (ICU). The investigators used direct observation of ICU teams on rounds, in order to analyze how clinicians responded to the inherent complexity of ICU care, and to determine how clinicians attempted to avoid error and adverse outcomes. Clinicians used a variety of mechanisms to establish "cooperative conditioning," a shared understanding of the patient's acute needs and risks, which maximizes patient safety by establishing a common group culture and approach to decision making. The authors' approach is derived from the seminal study of sensemaking in organizations, an account of the Mann Gulch disaster.